Pilot study

Adolescents with obesity (N = 48) and their caregivers were randomized to Multisystemic Therapy (MST) or a group weight-loss intervention. MST adolescents significantly reduced percents overweight and body fat, while control adolescents did not. Treatments such as MST that can intervene in the multiple systems that influence weight are worthy of further study.

Children with hyperlipidemia secondary to renal disease develop premature atherosclerosis and glomerulosclerosis. The aims of this pilot study were to find the dosage and short-term efficacy of simvastatin and potential adverse events in children with chronic kidney diseases. This was a random, double-blind, placebo-controlled, cross-over clinical trial performed on children with hyperlipidemia secondary to kidney disorders. After being placed on a diet for 3 months, patients were randomly placed in one of two balanced group blocks and treated with diet plus placebo or simvastatin at doses of 5 mg for children weighing 30 kg or less and 10 mg for children weighing over 30 kg, for 1 month, and then doubled for two more months. After this treatment, patients were placed on a diet for a 3-month washout period. During the last trial phase, patients previously treated with simvastatin were administered a placebo, and vice versa. A total of 25 patients with ages ranging from 4 years to 17 years were included in the study. A significant decrease in the levels of serum cholesterol (26.4%), low-density lipoprotein (LDL) (35.4%) and triglycerides (23.1%) was noted during the study, primarily during the simvastatin treatments, in which case cholesterol, LDL and triglycerides decreased by 23.3%, 33.7% and 21%, respectively. High-density lipoprotein (HDL) levels increased moderately (10.7%) during the study but without differences during simvastatin treatment. No differences were found across groups with respect to adverse events. In the short-term the combination of diet and simvastatin was effective in lowering hyperlipidemia in children with renal disorders.

Despite their historical significance to the UK's nursing profession, numbers of registered male nurses here have seldom exceeded 10% of the total. This is not an immutable principle, given that countries such as the Netherlands manage to attract males to the profession in much greater numbers. This paper examines and critiques the available literature on males in nursing from both a historical and present day perspective. In so doing, it discusses factors such as caring, over-performance and career progression, and, notions of masculinity. It then moves on to outline and discuss an on-going pilot study specifically designed to examine the motivations and experiences of a sample of preregistration and postregistration male nurses in the UK, across a range of ages and ethnicities. The ultimate aim of the study is to produce evidence which will advance the recruitment of men to a profession which is currently experiencing severe recruitment difficulties. The paper presents themes...

Oxygenation measurements are widely used in patient care. However, most clinically available instruments currently consist of contact probes that only provide global monitoring of the patient (e.g., pulse oximetry probes) or local monitoring of small areas (e.g., spectroscopy-based probes). Visualization of oxygenation over large areas of tissue, without a priori knowledge of the location of defects, has the potential to improve patient management in many surgical and critical care applications. In this study, we present a clinically compatible multispectral spatial frequency domain imaging (SFDI) system optimized for surgical oxygenation imaging. This system was used to image tissue oxygenation over a large area (16×12 cm) and was validated during preclinical studies by comparing results obtained with an FDA-approved clinical oxygenation probe. Skin flap, bowel, and liver vascular occlusion experiments were performed on Yorkshire pigs and demonstrated that over the course of the experiment, relative changes in oxygen saturation measured using SFDI had an accuracy within 10% of those made using the FDA-approved device. Finally, the new SFDI system was translated to the clinic in a first-in-human pilot study that imaged skin flap oxygenation during reconstructive breast surgery. Overall, this study lays the foundation for clinical translation of endogenous contrast imaging using SFDI.

Posttraumatic nightmares are a hallmark of PTSD and distinct from general nightmares as they are often repetitive and faithful representations of the traumatic event. This paper presents data from a pilot study that examined the use of Imagery Rehearsal in treating combat-related nightmares of 12 Vietnam veterans with PTSD. Three treatment groups, comprising 4 veterans in each, completed standardised treatment across 6 sessions. Treatment effects were investigated using nightmare diaries and established instruments, including the IES-R, BDI, BAI, and SCL-90-R. The data demonstrate significant reductions in nightmares targeted, and improvements in PTSD and comorbid symptomatology. The paper recommends that, on the basis of the promising preliminary data, a randomised control trial be established to assess imagery ability and attidude toward nightmares.

Aim  To determine the attitude of Spanish general dentists in relation to dental extraction in patients with heart valve prostheses subjected to acenocoumarol anticoagulation.Material and methods  A telephone survey was made of Spanish general dentists, asking about the indicated approach in the case of performing dental extractions in patients with heart valve prostheses subjected to acenocoumarol (Sintrom®) anticoagulation.Results  Of the 271 dentists answered, 175 were male (64.6%) and 96 were female (35.4%), with a mean professional experience of 20.17 ± 9.3 years. A total of 228 dentists (84.1%) indicated the need to refer the patient to a specialist for establishing the required approach, while 43 dentists (15.9%) did not consider such a measure to be necessary. Among this latter group of 43 dentists, 26 (60.5%) considered that acenocoumarol should be withdrawn or replaced by low-molecular weight heparin, while 17 (39.5%) were of the opinion that the anticoagulation regimen should not be modified. In relation to the international normalized ratio, 36 (83.7%) did not consider it necessary to request this parameter. As regards the prevention of endocarditis, 11 (25.6%) specified the need for prophylaxis, although only eight (72.7%) did so correctly. There were no statistically significant differences in behaviour in relation to either gender or years of professional experience.Conclusions  This study identifies a lack of knowledge on the part of the dentists regarding the approach to dental extraction in patients with heart valve prostheses subjected to anticoagulation. Due educational measures therefore should be reinforced among these professionals.